This document discusses the National Immunization Program (NIP) and Expanded Program on Immunization (EPI) in the Philippines. The EPI was established in 1976 to provide vaccines for infants/children and mothers against six diseases: tuberculosis, polio, diphtheria, tetanus, pertussis, and measles. The program aims to reduce morbidity and mortality from these and other vaccine-preventable diseases. It outlines the various vaccines recommended, including BCG, hepatitis B, pentavalent, polio, PCV, and MMR vaccines. It also describes strategies like routine immunization, supplemental immunization activities, and disease surveillance to control and eliminate targeted diseases.

1. NATIONALIMMUNIZATION PROGRAM (NIP)
EXPANDED PROGRAMFORIMMUNIZATION(EPI)
By: Mary Jane C. Eugenio, RN

2. NATIONAL IMMUNIZATION PROGRAM
◦ I. Rationale
◦ The Expanded Program on Immunization (EPI) was established in 1976 to ensure that infants/children and mothers have
access to routinely recommended infant/childhood vaccines.
◦ Six vaccine-preventable diseases were initially included in the EPI:
◦ tuberculosis,
◦ poliomyelitis,
◦ diphtheria,
◦ tetanus,
◦ pertussis and
◦ measles.
◦ In 1986, 21.3% “fully immunized” children less than fourteen months of age based on the EPI Comprehensive Program
review.

3. ◦ This program primarily aims
◦ to reduce the morbidity and mortality among children against the most common
vaccine-preventable diseases (VPDs) which includes;
◦ tuberculosis, poliomyelitis, diphtheria, tetanus, pertussis and measles.
To date, the Expanded Program on Immunization provides safe and effective
vaccines against Vaccine Preventable Diseases (VPDs) for newborns, infants,
older children, pregnant, and senior citizens.

4. ◦ II. Scenario
◦ Global Situation
◦ The burden
◦ In 2002, WHO estimated that 1.4 million of deaths among children under 5 years due
to diseases that could have been prevented by routine vaccination. This represents
14% of global total mortality in children under 5 years of age.

5. ◦ III. Interventions/ Strategies
Program Objectives/Goals:
◦ Over-all Goal:
To reduce the morbidity and mortality among children against
the most common vaccine-preventable diseases.

6. Specific Goals:
1. To immunize all infants/children against the most common vaccine-preventable diseases.
2. To sustain the polio-free status of the Philippines.
3. To eliminate measles infection.
4. To eliminate maternal and neonatal tetanus
5. To control diphtheria, pertussis, hepatitis b and German measles.
6. To prevent extra pulmonary tuberculosis among children.

7. Mandates:
◦ Republic Act No. 10152
“Mandatory Infants and Children Health Immunization Act of
2011”
Signed by President Benigno Aquino III in July 26, 2010. The mandatory
includes basic immunization for children under 5 including other types that will be
determined by the Secretary of Health.

8. Strategies:
 Conduct of Routine Immunization for Infants/Children/Women through
the Reaching Every Barangay (REB) strategy
 Supplemental Immunization Activity (SIA)
 Strengthening Vaccine-Preventable Diseases Surveillance

9. Conduct of Routine Immunization for Infants/Children/Women
through the Reaching Every Barangay (REB) strategy
 REB strategy, an adaptation of the WHO-UNICEF Reaching
Every District (RED), was introduced in 2004 aimed to improve the
access to routine immunization and reduce drop-outs.
 There are 5 components of the strategy, namely: data analysis for
action, re-establish outreach services, , strengthen links between the
community and service, supportive supervision and maximizing
resources.

10. Supplemental Immunization Activity (SIA)
Supplementary immunization activities are used to reach children
who have not been vaccinated or have not developed sufficient immunity
after previous vaccinations.
It can be conducted either national or sub-national –in selected
areas.

11. Strengthening Vaccine-Preventable Diseases Surveillance
◦ This is critical for the eradication/elimination efforts, especially in identifying
true cases of measles and indigenous wild polio virus
◦ Procurement of adequate and potent vaccines and needles and
syringes to all health facilities nationwide

12. Vaccine: BCG
Protection from: Tuberculosis
When to give: At birth
◦ Tuberculosis (TB) is an infection that most often attacks the lungs. In infants and young children, it affects other
parts of the body like the brain, bones, joints and other internal organs (extrapulmonary or miliary tuberculosis). A
severe case could cause serious complications or death. The BGC vaccine has a protective effect against meningitis
and disseminated TB in children.
◦ TB is very difficult to treat when contracted, and treatment is lengthy and not always successful. According to
the 2020 World Health Organization global TB report, the Philippines has the highest TB incidence rate in Asia, with
554 cases for every 100,000 Filipinos.

13. Vaccine: Hepatitis B
Protection from: Hepatitis B
When to give: At birth
◦ Hepatitis B virus is a dangerous liver infection that, when caught as an infant, often shows no symptoms for
decades. It can develop into cirrhosis and liver cancer later in life. Children less than 6 years old who become
infected with the hepatitis B virus are the most likely to develop chronic infections.

14. Vaccine: Pentavalent vaccine
Protection from: Diphtheria, Pertussis, Tetanus, Haemophilus
Influenzae type b and Hepatitis B
◦ When to give: 6, 10 and 14 weeks
◦ Diphtheria infects the nose, throat, tonsils and/or skin. The diphtheria toxin may cause obstructive pseudo-
membranes in the upper respiratory tract, making it hard for children to breathe and swallow. Severe cases can
cause paralysis, heart failure, kidney failure and sometimes death.
◦ Pertussis (whooping cough) causes coughing spells that can last for weeks. In some cases, it can lead to troubled
breathing, pneumonia, and death.
◦ Tetanus causes very painful muscle contractions. It can cause children’s neck and jaw muscles to lock (lockjaw),
making it hard for them to open their mouth, swallow, breastfeed or breathe. Even with treatment, tetanus is often
fatal.

15. ◦ Haemophilus Influenzae type b causes death and serious disease from meningitis and pneumonia in infants and
young children. Hib bacteria are carried in the human nasopharynx from where they can be transmitted to other
humans via droplets from nasopharyngeal secretions.
◦ 80–90% of infants infected with Hepatitis B during the first year of life are most likely to develop chronic infections.

16. Vaccine: Oral Polio Vaccine
When to give: 6, 10 and 14 weeks
Vaccine: Inactivated polio vaccine
When to give: 14 weeks and 9 months
Protection from: Poliovirus
◦ Polio is a virus that paralyzes 1 in 200 people who get infected. Among those cases, 5
to 10 per cent die when their breathing muscles are paralyzed. There is no cure for
polio once the paralysis sets in.

17. Vaccine: PCV
Protection from: Pneumonia and Meningitis
◦ When to give: 6, 10 and 14 weeks
◦ Pneumococcal diseases such as pneumonia and meningitis are a common cause of sickness and death worldwide,
especially among young children under 2 years old.

18. Vaccine: MMR
Protection from: Measles, Mumps and Rubella
◦ When to give: 9 months and 1 year old
◦ Measles is a highly contagious disease with symptoms that include fever, runny nose, white spots in the back of the
mouth and a rash. Most common complications are ear infection, diarrhea and pneumonia. Serious cases can cause
blindness, brain swelling and death.
◦ Mumps can cause headache, malaise, fever, and swollen salivary glands. Complications can include meningitis,
inflammation of the testicles and deafness.
◦ Rubella infection in children and adults is usually mild, but in pregnant women it can cause miscarriage, stillbirth,
infant death or birth defects in the eyes, ears, heart and brain (Congenital Rubella Syndrome).